Health Insurance Coverage: Estimates from the National Health Interview Survey, January-March 2017

August 29, 2017

Questions for Robin Cohen, Ph.D., Health Statistician and Lead Author on “Health Insurance Coverage: Estimates from the National Health Interview Survey, January-March 2017

Q: What do you think is the most interesting demographic finding among your new study’s short-term trends – age, poverty status, or race and ethnicity?

RC:  There are many interesting short-term trends presented in this report, though I would like to highlight the three that I find most interesting. Among poor adults aged 18 to 64, the percentage who were uninsured decreased from 42.2% in 2010 to 22.6% in the first 3 months of 2017. A similar decrease in the percentage of uninsured was seen for near poor adults aged 18 to 64, from 43.0% in 2010 to 23.0% in the first 3 months of 2017. Hispanic adults aged 18 to 64 had the greatest percentage point decrease in the uninsured rate from 2013 (40.6%) through the first 3 months of 2017 (24.1%).


Q: What is the most compelling long-term trend in your new health insurance report?

RC: It is quite striking and encouraging to see long-term improvements in health insurance coverage for children in the United States. The percentage of children who were uninsured generally decreased from 13.9% in 1997 to 5.3% in the first 3 months of 2017. The observed increase in the percentage of uninsured children from 4.5% in 2015 to 5.3% in the first 3 months of 2017 was not statistically significant. From 1997 to 2012, the percentage of children with private coverage has generally decreased, and the percentage of children with public coverage has generally increased. However, more recently, the percentage of children with public or private coverage has leveled off.


Q: Why aren’t state estimates presented?

RC: State level estimates of insurance coverage are not presented in the Early Release report based on the first 3 months of data from the National Health Interview Survey due to considerations of sample size and precision. However, state level estimates are included in the Health Insurance Early Release report three times a year, with the report based on 6 months of data, 9 months of data and a full year of data.


Q: It looks as though coverage through high-deductible private health insurance plans continues to rise in 2017; what patterns do your estimates show this year compared to previous years? 

RC: In the first 3 months of 2017, 42.3% of persons under age 65 with private health insurance coverage were enrolled in a high-deductible health plan (HDHP), an increase from 39.4% in 2016. The percentage of persons enrolled in an HDHP increased 17 percentage points from 25.3% in 2010 to 42.3% in the first 3 months of 2017.


 

Q: What is the take home message from this report? 

RC: I think the real take-home message from this report is the long-term trend of remarkable improvement in the number of uninsured Americans. In the first 3 months of 2017, 28.1 (8.8%) million persons of all ages were uninsured at the time of interview —20.5 million fewer persons than in 2010 (16.0%). However, there was no significant change from the 2016 uninsured rate of 9.0% (28.6 million).

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Health Care Access and Utilization among Native Hawaiians and Pacific Islanders Persons in the United States, 2014

August 18, 2017

Questions for Carla Zelaya, Survey Statistician and Lead Author on “Health Care Access and Utilization among Native Hawaiians and Pacific Islanders Persons in the United States, 2014

Q: What did your report find on health care access for the Native Hawaiian and Pacific Islander (NHPI) population?

CZ: Some of the main highlights of the report were NHPI adults were more likely to be insured, have public health coverage, have a usual place of care and a flu vaccination in the past 12 months compared with all U.S. adults. However, NHPI adults were also less likely to have private insurance, and those aged 65 and over were less likely to have ever received a pneumococcal vaccination compared with all U.S. adults.


Q: Is this the first published health data on NHPI population?

CZ: The Native Hawaiian and Pacific Islander National Health Interview Survey (NHPI NHIS), is the first federal survey designed exclusively to measure the health of the civilian non-institutionalized NHPI population of the United States. It was conducted by NCHS, and this is the third report published from the survey.

The first two reports are:

Citation #1: Galinsky AM, Zelaya CE, Simile C, Barnes PM. Health conditions and behaviors of Native Hawaiian and Pacific Islander persons in the United States, 2014. National Center for Health Statistics. Vital Health Stat 3(40). 2017.

https://www.cdc.gov/nchs/data/series/sr_03/sr03_040.pdf

Citation #2: Galinsky AM, Zelaya CE, Barnes PM, Simile C. Selected health conditions among Native Hawaiian and Pacific Islander adults: United States, 2014. NCHS data brief, no 277. Hyattsville, MD: National Center for Health Statistics. 2017.

https://www.cdc.gov/nchs/products/databriefs/db277.htm


Q: How do you collect data on the NHPI population?

CZ: To conduct the 2014 NHPI NHIS, NHIS field interviewers visited houses previously identified in the American Community Survey (ACS) to have at least one resident of any age with an NHPI racial identity (either alone or in combination with one or more other racial identities).


Q: Is there anything in the data that surprised you?

CZ: Within the NHPI population it was especially interesting that Native Hawaiians and Pacific Islanders adults differed in prevalence of uninsurance and private coverage (but not public coverage).


Q: What is the take home message from this report?

CZ: The prevalence of many indicators of access and utilization of health care among NHPI people differ from the total U.S. population and more specifically from Asians in the U.S. There was also diversity in access and utilization of health care within the NHPI population.


Stat of the Day – June 6, 2017

June 6, 2017


High-deductible Health Plans and Financial Barriers to Medical Care: Early Release of Estimates from the National Health Interview Survey, 2016

June 6, 2017

Questions for Robin Cohen, Ph.D., Health Statistician and Lead Author on “High-deductible Health Plans and Financial Barriers to Medical Care: Early Release of Estimates from the National Health Interview Survey, 2016

Q: Can you explain what high-deductible health plans (HDHP) are and why did you decide to look at this?

RC: High-deductible health plans (HDHP) are health insurance policies with higher deductibles than traditional plans. In 2016, a HDHP was defined as a health plan with an annual deductible of at least $1,300 for self-only coverage or $2,600 for family coverage. Traditional plans have annual deductibles below these levels. Relative to traditional plans, HDHPs tend to have lower premium costs. Because of the higher deductibles, persons enrolled in HDHPs can have higher out-of-pocket costs in the initial stages of care. We wanted to examine whether persons enrolled in HDHPs were more likely to forgo or delay care due to cost.


Q: How has the percentage of U.S. adults aged 18–64 with employment-based coverage enrolled in a HDHP changed from 2011-2016?

RC: The percentage of adults aged 18–64 with employment-based coverage enrolled in an HDHP increased from 26.3% in 2011 to 39.3% in 2016.


Q: What did your report find out among privately insured adults aged 18–64 with HDHPs?

RC:  In 2016, among privately insured adults aged 18–64, the percentage of those who did not get or delayed needed medical care due to cost in the past 12 months was significantly higher for those with an HDHP than those with a traditional plan.


Q: Was there anything in your report that surprised you?

RC: Regardless of the type of directly purchased coverage, adults with directly purchased coverage were more likely to not get or delay medical care due to cost than those with employment-based coverage.


Q: What is the take home message from this report?

RC: Among adults with private health insurance, those who have HDHPs are more likely to experience cost-related barriers to health care.


Stat of the Day – May 16, 2017

May 16, 2017


Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, 2016

May 16, 2017

Questions for Robin Cohen, Ph.D., Health Statistician and Lead Author on “Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, 2016

Q: Have the total number of uninsured leveled off since the Affordable Care Act (ACA) was implemented?

RC: In 2016, 28.6 million or 9.0% of persons of all ages were uninsured at the time of interview, this is 20 million fewer persons than in 2010 and no change from 2015. However, it is too soon to tell if there has been a leveling off in the number of uninsured.


Q: Since 2010, were there any trends among uninsured adults by age groups?

RC: Among adults aged 18–64, the rate of uninsurance at the time of interview remained relatively stable from 2010 through 2013 for all age groups except adults aged 18–24. Among adults aged 18–24 the percentage of those who were uninsured decreased from 31.5% in 2010 to 25.9% in 2011, and then remained stable through 2013. For all age groups, the percentage who were uninsured decreased significantly from 2013 through 2016.


Q: What did your report find on state-specific health insurance estimates for 2016?

RC: State-specific health insurance estimates for persons aged 18–64 in 2016 are presented for 45 states. Among these 45 states presented for 2016, California, Connecticut, Delaware, Hawaii, Illinois, Iowa, Maryland, Massachusetts, Michigan, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, Washington, and Wisconsin had significantly lower percentages of uninsured adults than the national average (12.4%). Florida, Georgia, Idaho, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, and Texas had significantly higher percentages of uninsured adults than the national average. Among the 45 states presented in this report, only California had a significant decrease in the percentage of adults aged 18–64 who were uninsured between 2015 (11.1%) and 2016 (9.5%).


Q: How come you only have data for 45 states instead of the whole country?

RC: Estimates are not presented for all 50 states and the District of Columbia due to considerations of sample size and precision. States with fewer than 1,000 interviews for persons of all ages are excluded. In addition, estimates for children in states that did not have at least 300 children with completed interviews are not presented.


Q: Was there anything in your report that surprised you?

RC: The percentage of persons aged 18–64 who were enrolled in exchange plans has remained relatively stable from the first quarter of 2016 (4.7% or 9.2 million) through the fourth quarter of 2016 (4.8% of 9.4) million. This was surprising because for both 2014 and 2015 we observed a drop in exchange coverage in the fourth quarter.


Stat of the Day – April 27, 2017

April 27, 2017